Halpern S W, Ellrodt G, Singh B N, Mandel W J
Br Heart J. 1980 Nov;44(5):589-95. doi: 10.1136/hrt.44.5.589.
The efficacy of intravenous procainamide, infused at 30 mg/min to a maximum dose of 20 mg/kg, in converting atrial fibrillation was evaluated under electrocardiographic and blood pressure control in 21 patients. Nine patients had atherosclerotic heart disease, seven had valvular lesions, five had hypertension, and six had no apparent heart disease. Nine patients (converters), who reverted to sinus rhythm at a mean dose of procainamide of 13.3 +/- 3.6 mg/kg (mean plasma concentration, 7.4 +/- 3.9 micrograms/ml) had normal echocardiographic left atrial diameters. All but one of the remainder, the 12 non-converters, who received a mean drug dose of 13.1 +/- 3.5 mg/kg (mean plasma concentration 13.9 +/- 7.6 micrograms/ml), had atrial diameters exceeding 4.0 cm. QRS and QTc intervals were not altered significantly in converters, but were prolonged significantly in non-converters. No serious side effects from the infusion were encountered. Intravenous procainamide infusion appears to be a safe and rapidly effective method of converting recent-onset atrial fibrillation to sinus rhythm in patients with normal left atrial dimensions.
在心电图和血压监测下，对21例患者静脉输注普鲁卡因胺（以30mg/min的速度输注，最大剂量为20mg/kg）转复房颤的疗效进行了评估。9例患者患有动脉粥样硬化性心脏病，7例有瓣膜病变，5例有高血压，6例无明显心脏病。9例（转复者）平均使用13.3±3.6mg/kg的普鲁卡因胺剂量（平均血浆浓度为7.4±3.9μg/ml）后恢复窦性心律，其超声心动图显示左房内径正常。其余12例未转复者（除1例例外）平均药物剂量为13.1±3.5mg/kg（平均血浆浓度13.9±7.6μg/ml），其心房直径均超过4.0cm。转复者的QRS和QTc间期无明显改变，但未转复者则显著延长。输注过程中未出现严重副作用。静脉输注普鲁卡因胺似乎是将近期发生的房颤转复为窦性心律的一种安全且快速有效的方法，适用于左房大小正常的患者。
